Breast reconstruction yet to catch on in Singapore

A patient gets ready for a mammogram. Breast reconstruction can be done in the same sitting as a mastectomy, usually taking tissue from the abdomen.
A patient gets ready for a mammogram. Breast reconstruction can be done in the same sitting as a mastectomy, usually taking tissue from the abdomen.ST FILE PHOTO

Doctors attribute low take-up rate to lack of awareness about procedure

Going under the knife for surgery is common among breast cancer patients, but breast reconstruction far less so.

At the National University Hospital, about 35 per cent of the 400 women who undergo breast cancer surgery each year choose to have breast reconstruction, said Dr Chan Ching Wan, a senior consultant at the division of general surgery (breast surgery).

And while nearly 250 patients go under the knife for mastectomies at Tan Tock Seng Hospital (TTSH) each year, less than a fifth choose to have their breasts reconstructed afterwards.

Overall, fewer than three in 10 Singaporean women who have undergone mastectomy opt for reconstructive surgery, The Straits Times' Mind Your Body reported in May.

Doctors attribute the low take-up rate to a lack of awareness about the procedure, but hope that this will change. "I think a lot of it is in the mindset," said Dr Juliana Chen, director of TTSH's breast clinic.

Reconstruction is usually an afterthought for many when they are first diagnosed with cancer.

"At that stage, most people would first think of getting rid of the disease," she said. "But we would like them to have a good quality of life too."

To raise awareness, the hospital organised a public forum earlier this month to mark Breast Cancer Awareness Month, which falls in October.

Breast cancer is one of the top cancers here, with about 1,600 women diagnosed each year between 2008 and 2012.

Dr Chen said that, in comparison, at least one in two mastectomy patients in Europe or the United States choose to have their breasts reconstructed. Referring to patients here, she added: "They have the mindset that it's a very big operation, and they are fearful."

Breast reconstruction can be done in the same sitting as a mastectomy, usually taking tissue from the patient's abdomen. However, the procedure can take up to eight hours instead of the one hour needed for mastectomy. This turns off many people.

One TTSH patient who declined to be named said that reconstruction was not on her mind when she was first diagnosed with breast cancer in 2009.

But within months of surgery, she began feeling self-conscious while giving talks as part of her job as a trainer, and eventually switched over to a desk-bound role. "It affected my self-confidence," said the 48-year- old, who is a commercial projects manager in an engineering firm.

"I had a prosthesis, but I would feel that it wasn't sitting right and that maybe people could tell."

She regained her self-esteem only after undergoing reconstructive surgery last year. "I never dreamt that I'd have the other breast back," she said. "Now I'm keen to go back to being a trainer."

linettel@sph.com.sg